Handwashing, Semmelweis, and chlorine.
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A microbial evaluation was made of adhesive plastic surgical drapes and cloth surgical drapes. These studies were done both during surgery and in the laboratory. The plastic drape does not allow bacterial penetration, lateral migration does not occur, skin bacteria do not multiply under the drape within the time periods studied and the patient drapes are held in place with their use. When wet, cloth drapes showed profuse bacterial penetration. Dry cloth showed less bacterial penetration as compared to wet cloth. Lateral migration under cloth drapes was not possible to assess due to a high level of penetration. The surface of cloth showed a higher level of bacterial contamination during the surgical procedures. Deep wound cultures collected just prior to closing showed 60% contamination when cloth was used compared to 6% when plastic was employed. The micro-organisms recovered from the various sites sampled were identified. Finally, in addition to the positive aseptic benefits afforded by plastic adhesive drapes, aesthetic features such as a more delineated operative field and elimination of towel clips make this product a useful adjunct to the surgeon's armamentarium.
New tests consisting of modifications of the inverted Mason jar test confirm our previously reported studies which showed that woven and nonwoven surgical materials vary greatly in their ability to serve as barriers against moist bacterial strike-through. Among the woven materials, only tightly woven Pima cloth or materials treated with Quarpel waterproofing process or with polythene layer lamination was invariably resistant. However, tight-woven Pima cloth, which had been treated with Quarpel became permeable after 100 washing-sterilizing cycles. Of the nonwoven materials, single-layer nonwoven materials tended to unevenly permeable to moist bacterial strike-through. Only the front and sleeves of nonwoven gowns reinforced with polyethelene layer were invariably resistant to moist contamination.
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137 internal jugular vein cannulae from 113 patients undergoing open heart surgery were cultured using standard broth culture and a semiquantitative culture technique. 60 of the cannulae were placed using an aseptic technique and 77 using a standard non sterile technique. Significant contamination was found in 18.3% of the cannulae in the aseptic group and 15.6% in the standard group. The contaminating organism was Staphylococcus epidermidis in 87.1% of cases. No advantage in using an aseptic technique of cannula insertion was demonstrated. It was concluded that the major source of contamination was elsewhere.
In a prospective randomised trial no significant difference in urinary infection was found when routine pubic shaving prior to transurethral surgery was compared with no pubic shave. An argument based on financial and aesthetic considerations is presented to support the abolition of this traditional policy.
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A field necropsy technique for cattle is described which avoids contamination by environmental mycobacteria of tissues intended for bacteriological examination. Settling the dust by hosing on and around the carcase, using sterile instruments for the collection of each tissue, excising lymph nodes without incising the capsule and submitting the nodes to the laboratory intact in saturated tetraborate solution resulted in uncontaminated samples even under adverse field conditions. The procedure is recommended for future investigations into the role of mycobacteria other than Mycobacterium bovis in the sensitisation of cattle to the intradermal test for tuberculosis.
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